|
National Catholic Reporter Friends Annual Appeal MY NAME:___________________________________________________________________ ADDRESS:__________________________________________________________________ CITY:________________________________________ STATE/PROVINCE_____________ ZIP/POSTAL CODE____________________ COUNTRY___________________________ YES, count me as a Friend of NCR: ____$50 ____$100 ____$250 ____$1000 ____Other ___ I also wish to give a gift subscription in addition to my Friends contribution (see below). I've included the $43.95 subscription fee. (Non-USA addresses, the subscription cost is $82.95.) ___ I do not want my name published in your annual list of donors. PAYMENT OPTIONS: NOTE -- All contributions are tax-deductible (United States). ___ Check enclosed. Please make check payable to National Catholic Reporter. (Mail to: 115 E. Armour Blvd., Kansas City, MO 64111, USA) Credit Card (Check one type of card.) ___ VISA ___ MASTERCARD Account # |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| Expiration Date Month |__|__| Year |__|__|__|__| CV2# |__|__|__| Card Verification Number (The last 3 numbers located on the back of your credit card inside the signature line.) Signature ___________________________________________ Phone (optional)______________________ E-mail (optional)______________________
Fill in below if you are giving a gift subscription in addition to your contribution. MY FRIENDS NAME:___________________________________________________________ ADDRESS:__________________________________________________________________ CITY:________________________________________ STATE/PROVINCE_____________ ZIP/POSTAL CODE____________________ COUNTRY___________________________
|